Katreena Collette Merrill1, Sharon Sumner2, Lorraine Linford3, Carrie Taylor2, Christopher Macintosh4. 1. Brigham Young University, College of Nursing, Provo, UT. Electronic address: Katreena.merrill@byu.edu. 2. Infection Prevention, Intermountain Medical Center, Murray, UT. 3. Intermountain Medical Center, Intravenous Therapy, Murray, UT. 4. School of Nursing, University of Utah, Salt Lake City, UT.
Abstract
BACKGROUND: Central line-associated bloodstream infections (CLABSIs) result in increased length of stay, cost, and patient morbidity and mortality. One CLABSI prevention method is disinfection of intravenous access points. The literature suggests that placing disinfectant caps over needleless connectors decreases CLABSI risk. METHODS: A quasi-experimental intervention study was conducted in a >430-bed trauma I center. In addition to an existing standard central line bundle, a new intervention consisting of a luer-lock disinfectant cap with 70% alcohol was implemented in all intravenous (IV) needleless connectors on patients with peripheral and central lines. Compliance to the disinfectant cap was monitored weekly. A generalized linear model using a Poisson distribution was fit to determine if there were significant relationships between CLABSIs and disinfectant cap use. Impacts on costs were also examined. RESULTS: The rate of CLABSI decreased following implementation of the disinfectant cap. The incidence rate ratios (.577, P = .004) for implementing the disinfectant caps was statistically significant, indicating that the rate of patient infections decreased by >40%. Increased compliance rates were associated with lower infection rates. Disinfectant cap use was associated with an estimated savings of almost $300,000 per year in the hospital studied. CONCLUSIONS: Use of a disinfectant cap on IV needleless connectors in addition to an existing standard central line bundle was associated with decreased CLABSI and costs.
BACKGROUND: Central line-associated bloodstream infections (CLABSIs) result in increased length of stay, cost, and patient morbidity and mortality. One CLABSI prevention method is disinfection of intravenous access points. The literature suggests that placing disinfectant caps over needleless connectors decreases CLABSI risk. METHODS: A quasi-experimental intervention study was conducted in a >430-bed trauma I center. In addition to an existing standard central line bundle, a new intervention consisting of a luer-lock disinfectant cap with 70% alcohol was implemented in all intravenous (IV) needleless connectors on patients with peripheral and central lines. Compliance to the disinfectant cap was monitored weekly. A generalized linear model using a Poisson distribution was fit to determine if there were significant relationships between CLABSIs and disinfectant cap use. Impacts on costs were also examined. RESULTS: The rate of CLABSI decreased following implementation of the disinfectant cap. The incidence rate ratios (.577, P = .004) for implementing the disinfectant caps was statistically significant, indicating that the rate of patient infections decreased by >40%. Increased compliance rates were associated with lower infection rates. Disinfectant cap use was associated with an estimated savings of almost $300,000 per year in the hospital studied. CONCLUSIONS: Use of a disinfectant cap on IV needleless connectors in addition to an existing standard central line bundle was associated with decreased CLABSI and costs.
Authors: Teryl K Nuckols; Emmett Keeler; Sally C Morton; Laura Anderson; Brian Doyle; Marika Booth; Roberta Shanman; Jonathan Grein; Paul Shekelle Journal: JAMA Intern Med Date: 2016-12-01 Impact factor: 21.873
Authors: Aaron M Milstone; Carol Rosenberg; Gayane Yenokyan; Danielle W Koontz; Marlene R Miller Journal: Infect Control Hosp Epidemiol Date: 2020-10-12 Impact factor: 3.254
Authors: Anna L Casey; Tarja J Karpanen; Peter Nightingale; Tom S J Elliott Journal: Antimicrob Resist Infect Control Date: 2018-04-05 Impact factor: 4.887